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Small Cities Initiative

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Finding Community Solutions to Substance Use Crises

The substance use crisis is a major public health issue that has hit communities hard, and smaller cities frequently lack the resources that larger ones have to address it effectively. Together with mayors and city representatives from small cities across Canada, we are working on regional solutions through our Small Cities Initiative. Join us for our Summer Webinar Series! Registration coming soon.

 

What Is The Small Cities Initiative?

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The focus of the Small Cities Initiative is developing the first municipally led, integrated standards for prevention, treatment, harm reduction, recovery, policing services, and policies and strategies, in a resource we call the “playbook.”

Thirty regions from coast to coast to coast have now significantly contributed to the playbook, launching this November at our Issues of Substance conference.

The “Initiative” encompasses the Timmins Summit, winter webinars and Municipal Leaders Table. It will also include our summer webinar series before the playbook launch. 

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How will this help? 

The playbook will provide municipal leaders with a consolidated range of evidence-based options they can choose from, based on their regional realities. It will help unlock vital government support, as well as reduce the growing polarization concerning this crisis.

To date, regions represented in the Small Cities Initiative include: Brantford, Brockville, Burlington, Cambridge, Campbell River, Charlottetown, Cobourg, Cornwall, Duncan City, Fredericton, Kensington, Lethbridge, Miramichi, New Westminster, North Battleford, North Cowichan, Northwest Territories, Orangeville, Penticton, Portage la Prairie, Powell River, Prince Albert, Prince County, Prince George, Queens, Red Deer, Stephenville, Thompson, Timmins and West Nipissing. 

The Initiative has multiple phases: 
•    Municipal Leaders Table — in Lethbridge, AB, April 2025 
•    Winter Virtual Sessions — February and March 2025
•    Timmins Summit — in Timmins, ON, September 2024

Coming up: 
•    Summer webinar series — exploring substance use health topics and introducing newcomers to the Initiative 
•    Playbook launch — at our Issues of Substance conference, November 2025
 

Municipalities that are interested in the project or would like to be kept informed on its development can contact us. Over the summer months, we will work to support communities through community engagement, training and education.  

Municipal Leaders Table

Mayors and city representatives from across Canada gathered in Lethbridge, Alberta, in April 2025, to start developing the playbook, a collection of approaches they can choose from to address the substance use crisis in small cities and towns.

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Read All About It

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Elected officials and community leaders came from coast to coast to coast. Senator Sharon Burey, who is known for her work in children’s mental health, equity and social justice, delivered the keynote address.

Attendees reviewed a variety of interventions, from health care and education, to bylaws, community safety measures, prevention and workplace programs. They were also asked to develop a table of contents for what they would need to make the playbook resource as practical as possible.

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News Release

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Global

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Canadian municipalities discuss opioid solutions in Lethbridge. 

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CTV

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Mayors from across Canada gather in Lethbridge for conference on opioid issues.

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CBC Homestretch

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Opioid conference in Lethbridge.

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Calgary Herald

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Canada’s small cities and towns facing same toxic drug issues as big cities.

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Bridge City News

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Mayors gather at Lethbridge to discuss opioid crisis.

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Lethbridge News Now

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Canadian mayors collaborating on opioid crisis strategies in Lethbridge.

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Our Media Compilation

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Later this spring, Timmins Mayor Michelle Boileau will engage additional mayors from across Canada and brief them on the initiative and playbook during the Federation of Canadian Municipalities’ Annual Conference and Trade Show in Ottawa, Ont. 

Open substance use in public spaces, rising numbers of substance use–related hospitalizations and deaths, and a lack of affordable and stable housing are only a few of the challenges small cities face as they attempt to better serve the needs of their communities.

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The substance use crisis is not just a big city issue...

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“it’s a whole-of-Canada issue that’s disproportionally affecting smaller cities and towns. We have the expertise in substance use health, but the mayors and municipal representatives here are the real experts on what their communities need. For the first time, we are bringing the two together to build effective and sustainable localized solutions.”
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Dr Alexander Caudarella
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CCSA CEO
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Winter Virtual Sessions

In February 2025 we hosted a virtual event as an introduction to this work. We were joined by mayors and city representatives from all across Canada: Our co-chair cities Lethbridge and Timmins, plus Brantford, Cambridge, Charlottetown, Duncan, Fredericton, Portage La Prairie, Prince George, Queens, Red Deer, Stephenville, Thompson and West Nipissing.

That group was joined by several new cities for our March 2025 virtual event: Brockville, Burlington, Campbell River, Cobourg, Cornwall, Kensington, Miramichi, New Westminster, North Cowichan, Orangeville, Penticton, Powell River, Prince Albert and Prince County.

These virtual sessions were leading up to the in-person Municipal Leaders Table.

Read Harnessing the Power of Community to Tackle the Toxic Drug Crisis for more insight into this initiative from our CEO Dr. Alexander Caudarella.

Continue reading to learn how this work began, with the Timmins Summit in September 2024. 

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Timmins Summit

We co-hosted a special event with the City of Timmins to examine the impact of the substance use crisis on small-sized cities across Canada. In a first-of-its-kind initiative, the Timmins Summit brought together elected leaders, public health officials, drug policy experts, local service providers, resource industry leaders and people with lived and living experience.

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Timmins Summit

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Here’s our CEO, Dr. Alexander Caudarella, speaking with Roxanne Carter-Thompson, Executive Director of the Adventure Group, a community outreach centre in Charlottetown, P.E.I. They discuss how integral municipal support is to creating home-grown solutions that address the harms from substance use, and why CCSA initiated the Timmins Summit.

Summary Report

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Timmins Summit Summary Report

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We are thrilled to share our summary report that reflects what was discussed by the 70 community leaders who attended. Here is a high-level overview:

  • The substance use crisis has evolved into a major public health issue, especially in smaller communities that frequently lack the authority and funding needed to address it effectively.
  • Addressing the issue is difficult due to a lack of local resources, burnout and staff shortages among service providers, stigma and public perception of substance use, the housing crisis, public drug use, a fragmented system of care and diverse regional challenges.
  • Indigenous communities, youth, people who are 2SLGBTQ+ and people recently released from incarceration are disproportionately impacted.
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Read All About It

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Our media advisory

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CBC Sudbury

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Conference in Timmins aims to find solutions to opioid crisis in smaller Canadian cities and towns.

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Timmins Daily Press

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Civic leaders descend on Timmins for national substance use crisis summit.

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CTV Calgary

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Lethbridge looking for new strategies to address substance abuse.

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North Bay Now

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West Nipissing represented in national discussions on substance use.

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Bridge City News

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Lethbridge Mayor speaks after substance use summit. 

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Our press release

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Watch: Senate of Canada Recognition

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In a Senate of Canada session on September 25, 2024, CCSA’s work is acknowledged by the Speaker and Senator Sharon Burey, who says, "Thank you for your tireless efforts and the hope you bring to those who need it most." Our Timmins Summit is also specifically mentioned.

Collaboration and Community

Join us as CCSA reaches out and brings people together to share expertise and strategies on topics like the drug toxicity crisis, new alcohol guidance, prevention and more.

While we focus on research to provide evidence-based solutions, we never forget that behind the science is the real impact on people, their families and friends. There is no one-size-fits-all solution — what works in a large city may not work in rural areas or small towns. By coming together, we can find grassroots ways to share what we know and address the problems we’re facing.

Together, we can ease a tremendous amount of suffering and make life a little better for many people.

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Latest CCSA Updates

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CCSA hosting mayors from across Canada to address impact of the substance use crisis on small cities
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Harnessing the Power of Community to Tackle the Toxic Drug Crisis
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Guidance, Tools and Resources

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CCSA produces research-based publications, tools, and resources to support evidence-based decision-making on substance use health issues. Select your area of interest from the categories below to learn more: 

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Substances

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CCSA produces a variety of substance use- and addiction-related publications for researchers, policy makers and health service providers. We provide guidance to decision makers through harnessing the power of research, collecting and organizing knowledge, and bringing together diverse perspectives. 

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Health and Public Safety

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CCSA conducts research, develops tools and resources, and produces targeted materials to support evidence-based decisions and public policy. Review our key resources on health and public safety in relation to substance use health and addiction issues.

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People and Communities

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CCSA is dedicated to the health and well-being of individuals and communities, focusing on the impact of substance use across the lifespan, the perspectives of people with lived experience, and the roles of stigma, sex and gender, and educators in substance use health.